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Monday, September 28, 2009

Kernicterus: A Problem That Has Not Gone Away

This week we release some early release articles that will herald almost a thematic focus in our upcoming October issue on hyperbilirubinemia and kernicterus. We have grouped these articles together into one issue rather than run them over several months because, together, they give us a comprehensive look at many facets concerning complication of elevated bilirubin levels.

For example, the article by Kuzniewicz et al. (DOI: 10.1542/peds.2008-2980) addresses the benefits and risks of implementing universal screening for hyperbilirubinemia using transcutaneous or total serum bilirubins. Varvarigou et al. (DOI: 10.1542/peds.2008-2322) offer us a new nomagram if we are to use trancutaneous measurements rather than serum bilirubins. Trikalinos et al. (DOI: 10.1542/peds.2008-3545) offer an evidence-based review of what has been published to date on the subject of screening for this problem. We are also including in the October issue the most recent US Preventive Services Task Force Recommendations on screening newborn infants for their risk of serious jaundice (DOI: 10.1542/peds.2009-0128). Finally commentaries by Maisels (DOI: 10.1542/peds.2009-0329), Newman (DOI: 10.1542/peds.2009-0412), and Fay (DOI: 10.1542/peds.2009-0190) try to make sense of the available evidence and guidelines to offer their perspective on how we should reduce the risk of kernicterus, when and how we should best measure the bilirubin level if we are going to measure it, and the merits of universal or more selective screening. Together, these articles are designed to shed as much new light (and not just ultraviolet light) as possible on this important topic for all practicing general pediatricians and neonatologists.